Individual
DREW SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 LINCOLN AVE, SAN JOSE, CA 95126-3705
(408) 278-3310
(408) 278-3378
Mailing address
400 RACE ST, SAN JOSE, CA 95126-3518
(408) 278-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G32274
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G322740
—
CA
Enumeration date
08/11/2006
Last updated
03/17/2008
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